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Article ; Online: Covid-19

Iacobucci, Gareth

What is the UK’s testing strategy?

2020 , Page(s) m1222

Keywords	covid19
Language	English
Publisher	BMJ
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.m1222
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: How could a pooled testing policy have performed in managing the early stages of the COVID-19 pandemic? Results from a simulation study.

Heath, Bethany / Villar, Sofía S / Robertson, David S

Statistics in medicine

2024 Volume 43, Issue 11, Page(s) 2239–2262

Abstract: ... testing policies based on individually testing subjects with symptoms (a policy resembling the UK strategy ... with COVID-19. However, it is very difficult to agree on the best policy when there are multiple conflicting ... at the start of the COVID-19 pandemic), individually testing subjects at random or pools of subjects randomly ...

Abstract	A coordinated testing policy is an essential tool for responding to emerging epidemics, as was seen with COVID-19. However, it is very difficult to agree on the best policy when there are multiple conflicting objectives. A key objective is minimizing cost, which is why pooled testing (a method that involves pooling samples taken from multiple individuals and analyzing this with a single diagnostic test) has been suggested. In this article, we present results from an extensive and realistic simulation study comparing testing policies based on individually testing subjects with symptoms (a policy resembling the UK strategy at the start of the COVID-19 pandemic), individually testing subjects at random or pools of subjects randomly combined and tested. To compare these testing methods, a dynamic model compromised of a relationship network and an extended SEIR model is used. In contrast to most existing literature, testing capacity is considered as fixed and limited rather than unbounded. This article then explores the impact of the proportion of symptomatic infections on the expected performance of testing policies. Symptomatic testing performs better than pooled testing unless a low proportion of infections are symptomatic. Additionally, we include the novel feature for testing of non-compliance and perform a sensitivity analysis for different compliance assumptions. Our results suggest for the pooled testing scheme to be superior to testing symptomatic people individually, only a small proportion of the population (
MeSH term(s)	Humans ; COVID-19/diagnosis ; COVID-19/epidemiology ; Computer Simulation ; COVID-19 Testing/methods ; COVID-19 Testing/statistics & numerical data ; Pandemics ; Models, Statistical ; SARS-CoV-2 ; Health Policy ; United Kingdom/epidemiology
Language	English
Publishing date	2024-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	843037-8
ISSN	1097-0258 ; 0277-6715
ISSN (online)	1097-0258
ISSN	0277-6715
DOI	10.1002/sim.10062
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Disentangling post-vaccination symptoms from early COVID-19.

EClinicalMedicine

2021 Volume 42, Page(s) 101212

Abstract: ... for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 ... Background: Identifying and testing individuals likely to have SARS-CoV-2 is critical ... anosmia/dysosmia, requisite symptoms for accessing UK testing; and many only had systemic symptoms ...

Abstract	Background: Identifying and testing individuals likely to have SARS-CoV-2 is critical for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 infection globally. Some individuals experience systemic symptoms post-vaccination, which overlap with COVID-19 symptoms. This study compared early post-vaccination symptoms in individuals who subsequently tested positive or negative for SARS-CoV-2, using data from the COVID Symptom Study (CSS) app. Methods: We conducted a prospective observational study in 1,072,313 UK CSS participants who were asymptomatic when vaccinated with Pfizer-BioNTech mRNA vaccine (BNT162b2) or Oxford-AstraZeneca adenovirus-vectored vaccine (ChAdOx1 nCoV-19) between 8 December 2020 and 17 May 2021, who subsequently reported symptoms within seven days (N=362,770) (other than local symptoms at injection site) and were tested for SARS-CoV-2 (N=14,842), aiming to differentiate vaccination side-effects Findings: Differentiating post-vaccination side-effects alone from early COVID-19 was challenging, with a sensitivity in identification of individuals testing positive of 0.6 at best. Most of these individuals did not have fever, persistent cough, or anosmia/dysosmia, requisite symptoms for accessing UK testing; and many only had systemic symptoms commonly seen post-vaccination in individuals negative for SARS-CoV-2 (headache, myalgia, and fatigue). Interpretation: Post-vaccination symptoms Funding: UK Government Department of Health and Social Care, Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK National Institute for Health Research, UK Medical Research Council and British Heart Foundation, Chronic Disease Research Foundation, Zoe Limited.
Language	English
Publishing date	2021-12-01
Publishing country	England
Document type	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2021.101212
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: COVID-19 War

Bhatia, Mrigesh / Bhatia, Charusheela / Bhatia, Vilomi

The International Journal of Community and Social Development

United Kingdom’s Strategy During the First Wave

2020 Volume 2, Issue 3, Page(s) 355–358

Abstract: This opinion piece is a reflection on the UK government’s policy response to the war against ... the COVID-19 pandemic. In the initial stages, concerns were raised with respect to a lack of effective ... wave of COVID-19. ...

Abstract	This opinion piece is a reflection on the UK government’s policy response to the war against the COVID-19 pandemic. In the initial stages, concerns were raised with respect to a lack of effective personal protective equipment, availability of ventilators and diagnostic tests. The early defective strategy based on the flawed assumption of building herd immunity in the population was quickly replaced with isolation and social distancing. Subsequently, testing and contact tracing were adopted which too has been criticised for being ‘too little, too late’. With the possibility of the second wave, the concern is the extent to which the United Kingdom has learnt lessons from the first wave and is in a position to effectively respond to the second wave of COVID-19.
Keywords	covid19
Language	English
Publisher	SAGE Publications
Publishing country	us
Document type	Article ; Online
ISSN	2516-6026
DOI	10.1177/2516602620964176
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Antibody testing for COVID-19

Emily R. Adams / Mark Ainsworth / Rekha Anand / Monique I. Andersson / Kathryn Auckland / J. Kenneth Baillie / Eleanor Barnes / Sally Beer / John I. Bell / Tamsin Berry / Sagida Bibi / Miles Carroll / Senthil K. Chinnakannan / Elizabeth Clutterbuck / Richard J. Cornall / Derrick W. Crook / Thushan de Silva / Wanwisa Dejnirattisai / Kate E. Dingle /

Christina Dold / Alexis Espinosa / David W. Eyre / Helen Farmer / Maria Fernandez Mendoza / Dominique Georgiou / Sarah J. Hoosdally / Alastair Hunter / Katie Jefferey / Dominic F. Kelly / Paul Klenerman / Julian Knight / Clarice Knowles / Andrew J. Kwok / Ullrich Leuschner / Robert Levin / Chang Liu / César López-Camacho / Jose Martinez / Philippa C. Matthews / Hannah McGivern / Alexander J. Mentzer / Jonathan Milton / Juthathip Mongkolsapaya / Shona C. Moore / Marta S. Oliveira / Fiona Pereira / Elena Perez / Timothy Peto / Rutger J. Ploeg / Andrew Pollard / Tessa Prince / David J. Roberts / Justine K. Rudkin / Veronica Sanchez / Gavin R. Screaton / Malcolm G. Semple / Jose Slon-Campos / Donal T. Skelly / Elliot Nathan Smith / Alberto Sobrinodiaz / Julie Staves / David I. Stuart / Piyada Supasa / Tomas Surik / Hannah Thraves / Pat Tsang / Lance Turtle / A. Sarah Walker / Beibei Wang / Charlotte Washington / Nicholas Watkins / James Whitehouse / National COVID Testing Scientific Advisory Panel

Wellcome Open Research, Vol

A report from the National COVID Scientific Advisory Panel [version 1; peer review: 2 approved]

2020 Volume 5

Abstract: Background: The COVID-19 pandemic caused >1 million infections during January-March 2020. There is ... result (n=40), and pre-pandemic negative control samples banked in the UK prior to December-2019 (n=142 ... However, ELISA can be calibrated to be specific for detecting and quantifying SARS-CoV-2 IgM and IgG and is ...

Abstract	Background: The COVID-19 pandemic caused >1 million infections during January-March 2020. There is an urgent need for reliable antibody detection approaches to support diagnosis, vaccine development, safe release of individuals from quarantine, and population lock-down exit strategies. We set out to evaluate the performance of ELISA and lateral flow immunoassay (LFIA) devices. Methods: We tested plasma for COVID (severe acute respiratory syndrome coronavirus 2; SARS-CoV-2) IgM and IgG antibodies by ELISA and using nine different LFIA devices. We used a panel of plasma samples from individuals who have had confirmed COVID infection based on a PCR result (n=40), and pre-pandemic negative control samples banked in the UK prior to December-2019 (n=142). Results: ELISA detected IgM or IgG in 34/40 individuals with a confirmed history of COVID infection (sensitivity 85%, 95%CI 70-94%), vs. 0/50 pre-pandemic controls (specificity 100% [95%CI 93-100%]). IgG levels were detected in 31/31 COVID-positive individuals tested ≥10 days after symptom onset (sensitivity 100%, 95%CI 89-100%). IgG titres rose during the 3 weeks post symptom onset and began to fall by 8 weeks, but remained above the detection threshold. Point estimates for the sensitivity of LFIA devices ranged from 55-70% versus RT-PCR and 65-85% versus ELISA, with specificity 95-100% and 93-100% respectively. Within the limits of the study size, the performance of most LFIA devices was similar. Conclusions: Currently available commercial LFIA devices do not perform sufficiently well for individual patient applications. However, ELISA can be calibrated to be specific for detecting and quantifying SARS-CoV-2 IgM and IgG and is highly sensitive for IgG from 10 days following first symptoms.
Keywords	Medicine ; R ; Science ; Q
Subject code	630
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	Wellcome
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Health visiting in the UK in light of the COVID-19 pandemic experience (RReHOPE)

Geoff Wong / Erica Gadsby / Claire Duddy / Madeline Bell / Emma King / Sally Kendall

BMJ Open, Vol 13, Iss

a realist review protocol

2023 Volume 3

Abstract: ... their objectives. The COVID-19 pandemic rapidly disrupted service delivery from March 2020. This realist review ... organised and delivered in very different ways in different parts of the UK. While there has been attention ... to the key components of health visiting practice and what works well and how, there is little research ...

Abstract	Introduction Health visiting services, providing support to under 5s and their families, are organised and delivered in very different ways in different parts of the UK. While there has been attention to the key components of health visiting practice and what works well and how, there is little research on how health visiting services are organised and delivered and how that affects their ability to meet their objectives. The COVID-19 pandemic rapidly disrupted service delivery from March 2020. This realist review aims to synthesise the evidence on changes during the pandemic to identify the potential for improving health visiting services and their delivery.Methods and analysis This review will follow the RAMESES (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) quality standards and Pawson’s five iterative stages to locate existing theories, search for evidence, select literature, extract data, synthesise evidence and draw conclusions. It will be guided by stakeholder engagement with practitioners, commissioners, policymakers, policy advocates and people with lived experience. This approach will consider the emerging strategies and evolving contexts in which the services are delivered, and the varied outcomes for different groups. A realist logic of analysis will be used to make sense of what was happening to health visiting services during and following the pandemic response through the identification and testing of programme theories. Our refined programme theory will then be used to develop recommendations for improving the organisation, delivery and ongoing postpandemic recovery of health visiting services.Ethics and dissemination General University Ethics Panel approval has been obtained from University of Stirling (reference 7662). Dissemination will build on links to policymakers, commissioners, providers, policy advocates and the public. A range of audiences will be targeted using outputs tailored to each. A final stakeholder event focused on knowledge mobilisation will aid ...
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Covid 19: Where’s the strategy for testing?

Godlee, Fiona

BMJ

Abstract: It would be nice to be able to say otherwise, but the UK’s approach to testing in this covid-19 ... than clear strategy Allan Wilson, president of the Institute of Biomedical Sciences, has called this reactive ... The system is far from “world beating,” and ministers must be prepared to acknowledge and learn from mistakes ...

Abstract	It would be nice to be able to say otherwise, but the UK’s approach to testing in this covid-19 pandemic continues to be chaotic, centralised, commercialised, and driven by numerical targets rather than clear strategy Allan Wilson, president of the Institute of Biomedical Sciences, has called this reactive and random approach the “wild west of testing ”1 Writing for BMJ Opinion this week, Chris Ham agrees The system is far from “world beating,” and ministers must be prepared to acknowledge and learn from mistakes, he says 2 What makes matters worse is the ongoing lack of honesty The government has exaggerated the performance of its much vaunted test, track, and trace system: most …
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #630099
Database	COVID19

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Article ; Online: Disentangling post-vaccination symptoms from early COVID-19

medRxiv

Abstract: ... for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 ... testing criteria. Findings: Differentiating post-vaccination side-effects alone from early COVID-19 was ... Background: Identifying and testing individuals likely to have SARS-CoV-2 is critical ...

Abstract	Background: Identifying and testing individuals likely to have SARS-CoV-2 is critical for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 infection globally. Some individuals experience systemic symptoms post-vaccination, which overlap with COVID-19 symptoms. This study compared early post-vaccination symptoms in individuals who subsequently tested positive or negative for SARS-CoV-2, using data from the COVID Symptom Study (CSS) app. Design: We conducted a prospective observational study in UK CSS participants who were asymptomatic when vaccinated with Pfizer-BioNTech mRNA vaccine (BNT162b2) or Oxford-AstraZeneca adenovirus-vectored vaccine (ChAdOx1 nCoV-19) between 8 December 2020 and 17 May 2021, who subsequently reported symptoms within seven days (other than local symptoms at injection site) and were tested for SARS-CoV-2, aiming to differentiate vaccination side-effects per se from superimposed SARS-CoV-2 infection. The post-vaccination symptoms and SARS-CoV-2 test results were contemporaneously logged by participants. Demographic and clinical information (including comorbidities) were also recorded. Symptom profiles in individuals testing positive were compared with a 1:1 matched population testing negative, including using machine learning and multiple models including UK testing criteria. Findings: Differentiating post-vaccination side-effects alone from early COVID-19 was challenging, with a sensitivity in identification of individuals testing positive of 0.6 at best. A majority of these individuals did not have fever, persistent cough, or anosmia/dysosmia, requisite symptoms for accessing UK testing; and many only had systemic symptoms commonly seen post-vaccination in individuals negative for SARS-CoV-2 (headache, myalgia, and fatigue). Interpretation: Post-vaccination side-effects per se cannot be differentiated from COVID-19 with clinical robustness, either using symptom profiles or machine-derived models. Individuals presenting with systemic symptoms post-vaccination should be tested for SARS-CoV-2, to prevent community spread. Funding: Zoe Limited, UK Government Department of Health and Social Care, Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK National Institute for Health Research, UK Medical Research Council and British Heart Foundation, Alzheimer9s Society, Chronic Disease Research Foundation, Massachusetts Consortium on Pathogen Readiness (MassCPR).
Keywords	covid19
Language	English
Publishing date	2021-07-22
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.07.21.21260906
Database	COVID19

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Article ; Online: Disentangling post-vaccination symptoms from early COVID-19

EClinicalMedicine, Vol 42, Iss , Pp 101212- (2021)

2021

Abstract: ... for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 ... Background: Identifying and testing individuals likely to have SARS-CoV-2 is critical ... machine learning and multiple models considering UK testing criteria. Findings: Differentiating post-vaccination ...

Abstract	Background: Identifying and testing individuals likely to have SARS-CoV-2 is critical for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 infection globally. Some individuals experience systemic symptoms post-vaccination, which overlap with COVID-19 symptoms. This study compared early post-vaccination symptoms in individuals who subsequently tested positive or negative for SARS-CoV-2, using data from the COVID Symptom Study (CSS) app. Methods: We conducted a prospective observational study in 1,072,313 UK CSS participants who were asymptomatic when vaccinated with Pfizer-BioNTech mRNA vaccine (BNT162b2) or Oxford-AstraZeneca adenovirus-vectored vaccine (ChAdOx1 nCoV-19) between 8 December 2020 and 17 May 2021, who subsequently reported symptoms within seven days (N=362,770) (other than local symptoms at injection site) and were tested for SARS-CoV-2 (N=14,842), aiming to differentiate vaccination side-effects per se from superimposed SARS-CoV-2 infection. The post-vaccination symptoms and SARS-CoV-2 test results were contemporaneously logged by participants. Demographic and clinical information (including comorbidities) were recorded. Symptom profiles in individuals testing positive were compared with a 1:1 matched population testing negative, including using machine learning and multiple models considering UK testing criteria. Findings: Differentiating post-vaccination side-effects alone from early COVID-19 was challenging, with a sensitivity in identification of individuals testing positive of 0.6 at best. Most of these individuals did not have fever, persistent cough, or anosmia/dysosmia, requisite symptoms for accessing UK testing; and many only had systemic symptoms commonly seen post-vaccination in individuals negative for SARS-CoV-2 (headache, myalgia, and fatigue). Interpretation: Post-vaccination symptoms per se cannot be differentiated from COVID-19 with clinical robustness, either using symptom profiles or machine-derived models. ...
Keywords	COVID-19 detection ; Vaccination ; Side-effects ; Self-reported symptoms ; Mobile technology ; Early detection ; Medicine (General) ; R5-920
Subject code	150
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: How could a pooled testing policy have performed in managing the early stages of the COVID-19 pandemic? Results from a simulation study

Heath, Bethany / Villar, Sofía S. / Robertson, David S.

medRxiv

Abstract	A coordinated testing policy is an essential tool for responding to emerging epidemics, as was seen with COVID-19. However, it is very difficult to agree on the best policy when there are multiple conflicting objectives. A key objective is minimising cost, which is why pooled testing (a method that involves pooling samples taken from multiple individuals and analysing this with a single diagnostic test) has been suggested. In this paper, we present results from an extensive and realistic simulation study comparing testing policies based on individually testing subjects with symptoms (a policy resembling the UK strategy at the start of the COVID-19 pandemic), individually testing subjects at random or pools of subjects randomly combined and tested. To compare these testing methods, a dynamic model compromised of a relationship network and an extended SEIR model is used. In contrast to most existing literature, testing capacity is considered as fixed and limited rather than unbounded. This paper then explores the impact of the proportion of symptomatic infections on the expected performance of testing policies. Only for less than 50% of infections being symptomatic does pooled testing outperform symptomatic testing in terms of metrics such as total infections and length of epidemic. Additionally, we present the novel feature for testing of non-compliance and perform a sensitivity analysis for different compliance assumptions. Our results suggest for the pooled testing scheme to be superior to testing symptomatic people individually, only a small proportion of the population (>2%) needs to not comply with the testing procedure.
Keywords	covid19
Language	English
Publishing date	2023-06-06
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2023.06.05.23290956
Database	COVID19

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